Individual provider Active NPI

Stuart Kolber, OPTOMOTRIST

  • Optometrist
  • Lawrenceville, NJ
National Provider Identifier
1750331799
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00376600 Issued in NJ
Practice address
2495 Route 1
Ste. 8
Lawrenceville, NJ 08648
Phone
(609) 882-2888
NPI assigned
May 11, 2006
Last updated
Jan 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00376600 NJ Primary

Addresses

Primary practice location

2495 Route 1
Ste. 8
Lawrenceville, NJ 08648

Mailing address

2495 Route 1
Ste. 8
Lawrenceville, NJ 08648
Phone (609) 882-2888

Other identifiers 1

IdentifierTypeStateIssuer
2255201KMedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110204000841 NJ Practitioner - Optometry 3971510330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Vision Services, PAGroup PAC ID 1254348600, 3 clinicians

Practice addresses (Care Compare)

2495 Route 1
Suite 8
Lawrenceville, NJ 08648-4099
Phone (609) 882-2888

2495 RT
1 Suite 8
Lawrenceville, NJ 08648-4099

Allied Vision Serv PA
2495 RT 1 Suite 8
Lawrenceville, NJ 08648-4099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00376600NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Vision Services, PA Optometrist CurrentSince Jan 1, 1979 Accepting new patients
Total Eye Care Centers, PC Past Accepting new patients
Mercer Vision Associates Optometrist PastSince Nov 14, 1999 Accepting new patients
Jason Lam O.D., M.B.a., Inc. Optometrist Past Accepting new patients

Locations

2495 US Highway 1
Ste 8
Lawrenceville, NJ 08648
Phone (609) 882-2888

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1750331799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 ROUTE 1",
            "address_2": "STE. 8",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-882-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 ROUTE 1",
            "address_2": "STE. 8",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-882-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBER",
        "first_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "OPTOMOTRIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00376600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2255201K",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.